Senior Director, Provider Enrollment in Brentwood, TN at Health Support Center

Date Posted: 6/8/2018

Job Snapshot

Job Description

Health Support Center

POSITION SUMMARY:

The Senior Director, Provider Enrollment is responsible for leading, developing and implementing, and cultivating the strategies and processing for enrolling our employed providers with governmental and contracted commercial payers.  The Senior Director will play an integral role in the onboarding process with new providers.

ESSENTIAL FUNCTIONS:  To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation. 

Serve as Subject Matter Expert (SME) to all LifePoint leaders, including the Market Director/Senior Directors, Physician Service VP’s and Group Leadership and lead Company-wide efforts regarding enrollment of providers with governmental and contracted payers.

Develop, implement, and manage key performance indicator reporting to assess the productivity and accuracy of enrollment specialist performance.

Identify and report the progress of enrollment activities, including, but not limited to, application statuses, hold and related write off activity, and trended activity. Assist in prioritization of activities to minimize any cash flow disruption.

Collaborate and coordinate with multiple departments within the Health Support Center (HSC) to maximize efficiency and effectiveness of enrollments, as well as maintain documentation necessary for verification of enrollment status.

Serve as the Provider enrollment representative for all strategic acquisitions and in-market transactions and divestitures to ensure that enrollment activities are completed timely and in the most appropriate manner to reduce any disruption in cash flow.

Lead implementation of appropriate education and policies on enrollment of providers with insurance payers helping ensure an effective and efficient enrollment process. Meet with payors as needed for items that need escalation.

Lead efforts, in coordination with the Managed Care and Government relations teams, to facilitate legislative action where advantageous.

Review, resolve, and communicate contract and claims issues related to provider enrollment to senior leadership, including Physician Services, Group and Hospital Leadership.

Serve as authorized official for Provider Enrollment, Chain and Ownership System (PECOS); responsible for reviewing all federal payer applications.

Job Requirements

SUPERVISORY RESPONSIBILITIES:

 

Manage the work of others, including planning, assigning, scheduling and reviewing work, ensures quality standards. Responsible for hiring, terminating, training and developing, reviewing performance and administering corrective action for staff.

KNOWLEDGE, SKILLS & ABILITIES: The requirements listed below are representative of the knowledge, skills and/or abilities required.

Education: Bachelor’s Degree or any equivalent combination of education, experience, and training that provides the required knowledge, skills, and abilities; Master's Degree preferred.

 

Experience: Minimum 10 years of credentialing or provider enrollment experience, including 2+ years in a supervisory role


Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran

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